How i work

One of the biggest question that we ask when looking for a therapist is, will it be helpful? When shifting through the options of therapists we will often then ask ourselves, “would this therapist or therapy be a good fit for me?” What we know from outcome research is that the “fit” is the most important question. We have gone on believing that technique/skills/expertise of the therapist is the deliverer of good outcomes but in fact it is only a small percentage of the outcome. The largest determinant of a successful outcome actually comes from the fit between the client and the therapist. Pretty amazing right? The therapist works for who you uniquely are and your unique needs for therapy. Your story, values and intentions are what are most important not the model/skills/expertise of the therapist. Understanding this it radically changes what we might look for out of therapy. Instead of expertise we might look for a therapist that will get what is unique about you, what you need, and what this looks like in terms of what we might do to produce the change that is the most important for you. In other words, you need a tailor not just buy off the rack. Of course that is not to say what we do as technique is not important. It’s just what we do has to feel right to you. That is in part why I practice Narrative Therapy (NT). NT is about a respectful engagement that is honoring of people’s unique stories. It is hopeful and helps guide people back to their version of a meaningful life. It does not rely on diagnosis to tell the story of your life, it relies on you. Problem focused work leaves too much out about who you are and your preferences for living under the trick of certainty. Through thoughtful questions we will help reclaim or discover your path in life. Your life is of a Litterary Merit.

Narrative Therapy takes us away from the medical model which locates problems in pathological or “what’s wrong with you” terms. The narrative metaphor brings us to a place of locating people’s stories directly in the land of living art. Through working in a Narrative Therapy model the poetic construction of the person’s story is what matters. That is, the narrative metaphor focuses on the lived experience and meaning people make in their lives through story. It is the person’s story that is being told in therapy not a biological, internalizing, or the often oppressive demands of modern life. This opens the door to conversations that are not bound by symptom management, but are cracks of light to creative conversations that bring forth unique counter steps to problem stories. This invites the “answer” to the problem story to come from the vast resources of the person’s own way of understanding their life. This door opening reveals that art, nature, spirit, poetry, ancestry, the “vast perhaps”, and our life experience can become guides to reclaiming a person’s life back from problem saturated stories that we might come to therapy with.
In sessions with me, I aim to work collaboratively with the people coming to me, where we can work together to co-construct the change people are seeking. I do this in two ways: 1. By asking questions and 2. Seeking a shared understanding of the concerns and or resistance to these problems. Questions make mischief or unsettle problem stories. They bring us to the land of what is possible outside of the confinements of often thin problem ideas, like the should’s of life or how we measure ourselves up (or down). Questions center the knowledge with you. They also lead to curiosity, creativity, hope, and self wonderment. They help separate problem stories from a sense of identity which gives you space to fill in the vastness of your preferred meaning from the material around you that could be there or has always been there. Question can often lead to a person’s own unique tailored problem solving skills rather than cookie cutter coping skills that wouldn’t know you from anything else.
Here are some examples of questions:
“What does the problem say about what is important to you in your life?”
“Where did the inspiration for being here today come from?”
“What has this problem taken from you that you want back?”
“Who would be least surprised to hear you say that? What do they know about you that would tell a different story than the problem is wanting to tell about you?”
The Narrative Therapy approach works with all people regardless of age, problem story, or how many people are involved in the conversation (present in the session or brought forth in conversation). This way of working has not only been highly effective with the people I work with but it has also enriched my life as I have been learned and been inspired by being connected through people’s amazing lived experience.
I have enjoyed working in collaboration with teens, families, and adults through out my career and I look forward to having more space in my practice to let these stories breathe as they are wanting to do
NFT is being a help guide a family to their preferred future together. My stance is based on respect for your families desired path in hopes that we connect your family to preferred ways of being that is at the same time honoring of your family history, culture, expectations, and preferably unique to you. Often we can be heavily influenced by the competing influences of our society’s expectations for family’s. Have you gotten upset at your child over homework only to realize that homework is not more important than the relational conflict it causes. Pressure starts to trickle down into families ways of being with each other. In this we often miss how we might share goals, hopes, or expectations for how families can work together.
I am certified trainer for the International Center for Clinical Excellence (ICCE) with the esteemed psychologist Scott Miller and colleagues. This allows me to work with organizations and individuals interested in improving their care with clients. Through the ICCE we look at what works in therapy and how to implement what is called the core therapuetic factors. What is found in the meta analysis is that the most potent ask of seeking help is having a partnership between the client and the therapist. WIth all relationships, especially ones with a specific purpose, is that this is not a static place but requires ongoing monitoring. Change is hard, having a collaborative guide in this change helps achieve bigger and more reliable change. As an ICCE trainer we use rounding outcome monitoring (ROM) to help guide this process. This includes monitoring the ongoing therapuetic relationship between the therapist and client using ROM forms. Using how the client is responding to treatment along with how the client is feeling in the relationship with the therapist Feedback Informed Treatment (FIT), I have had over 15 years practicing FIT and have been the Northern California Lead in FIT for a large managed care company, leading over hundreds of clinicians in improving their clinical practice, implementing FIT in the organizational practices, and developing trainings and programs for N. California and National programs.
Working with FIT with in a large organization uniquely prepares me to work with other mental health organizations. As part of my role, I helped to develop feedback measures, implemented programs, and taught our staff across the region. I helped guide hundreds of clinicians to improve their effectiveness with the people that come to see them for help by having clinicians put the client’s feedback about how therapy is going at the center of the conversation. I also help clinicians in the organization identify areas in their practice that can be improved to lead to better outcomes and develop a plan to achieve better results. This is called Deliberate Practice (DP) which is an evidence based practice to improve outcomes for individual clinicians, I would love to be able to consult with clinicians looking to use or increase their effectiveness using FIT. I am also available to meeting with organization looking to implement FIT into organizational practice.